Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33441
Title: Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study.
Austin Authors: Zarbock, Alexander;Weiss, Raphael;Albert, Felix;Rutledge, Kristen;Kellum, John A;Bellomo, Rinaldo ;Grigoryev, Evgeny;Candela-Toha, Angel M;Demir, Z Aslı;Legros, Vincent;Rosenberger, Peter;Galán Menéndez, Patricia;Garcia Alvarez, Mercedes;Peng, Ke;Léger, Maxime;Khalel, Wegdan;Orhan-Sungur, Mukadder;Meersch, Melanie
Affiliation: Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.;Outcome Research Consortium, Cleveland, OH, USA.
Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany.
Department of Anesthesiology and Perioperative Medicine, University of Alabama, Birmingham, USA.
Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Critical Care, The University of Melbourne, Melbourne, Australia.
Department of Anesthesiology, Kemerovo Cardiology Centre, Kemerovo, Russia.
Department of Anesthesiology, University Hospital Ramón y Cajal, Madrid, Spain.
Department of Anesthesiology, Ankara Bilkent City Hospital, Health Science University, Ankara, Turkey.
Department of Anesthesiology and Critical Care, Hôpital Maison Blanche, University Hospital, 51100, Reims, France.
Department of Anesthesiology and Intensive Care, University Hospital Tübingen, Tübingen, Germany.
Department of Anesthesiology and Intensive Care, University Hospital Vall d'Hebron, Barcelona, Spain.
Department of Anesthesiology, Hospital de Sant Pau, University of Barcelona, Barcelona, Spain.
Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Anesthesiology and Intensive Care, Centre Hospitalier Universitaire d'Angers, Angers, France.
Department of Anesthesiology, Tripoli Central Hospital, Tripoli, Libya.
Department of Anesthesiology and Reanimation, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
Department of Intensive Care, Royal Melbourne Hospital, Parkville, VIC, Australia.
Intensive Care
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Issue Date: Dec-2023
Date: 2023
Publication information: Intensive Care Medicine 2023-12; 49(12)
Abstract: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide.
URI: https://ahro.austin.org.au/austinjspui/handle/1/33441
DOI: 10.1007/s00134-023-07169-7
ORCID: 0000-0002-2124-1714
Journal: Intensive Care Medicine
PubMed URL: 37505258
ISSN: 1432-1238
Type: Journal Article
Subjects: Acute kidney injury
Epidemiology
Mortality
Perioperative
Postoperative
Appears in Collections:Journal articles

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